Rapid oncological diagnosis of lung cancer patients — specific facility experience

Introduction: In order to improve diagnosis procedure by public health service, an organizational solution called Rapid Oncological Therapy has been introduced. The introduction of this program caused criticism of the medical community, and state control authorities showed irregularities in its functioning in medical clinics. Its aim was to assess this process among lung cancer patients hospitalized in the Clinic for 9 months. Material and methods: After the analysis of imaging tests, the patients were qualified for invasive tests (bronchoscopy, EBUS). Patients with histopathological diagnosis of NSCLC were subjected to molecular diagnostics. After completing the diagnosis and establishing the final diagnosis, the patient's forfeiture was presented at the clinical meeting. Results: The analysis involved 209 patients who had a DILO card issued. 156 patients were diagnosed with lung cancer and qualified for the consulate. Among the histopathological types, NSCLC dominated — 80%. SCLC was 17% of the types. By the decision made on medical case conference, 135 patients have been qualified for casual treatment, among others 12% surgical treatment; 47% chemotherapy, 18% radiotherapy; 8% chemo-radiotherapy. An average waiting time for diagnosis process to begin, after DILO card has been issued was 16.33 (± 18.78) days, an average hospitalization and diagnosis time was 9.16 (± 6.61) days. Around 31.3 (± 14.93) days on average have passed from the start of diagnostical hospitalization until beginning of the causal treatment. Conclusions: In a multi-specialist center, it is possible to develop a care model for lung cancer patients, consistent with Rapid Oncological Diagnosis

Treatment of acute respiratory failure in the course of COVID-19. Practical hints from the expert panel of the Assembly of Intensive Care and Rehabilitation of the Polish Respiratory Society

In 2019, a pandemic began due to infection with a novel coronavirus, SARS-CoV-2. In many cases, this coronavirus leads to the development of the COVID-19 disease. Lung damage in the course of this disease often leads to acute hypoxic respiratory failure and may eventually lead to acute respiratory distress syndrome (ARDS). Respiratory failure as a result of COVID-19 can develop very quickly and a small percent of those infected will die because of it. There is currently no treatment for COVID-19, therefore the key therapeutic intervention centers around the symptomatic treatment of respiratory failure. The main therapeutic goal is to main-tain gas exchange, mainly oxygenation, at an appropriate level and prevent the intensification of changes in the lung parenchyma. Depending on the severity of hypoxemia different techniques can be used to improve oxygenation. Medical staff dealing with COVID-19 patients should be familiar with both, methods used to treat respiratory failure and the epidemiological risks arising from their use. In some patients, conventional (passive) oxygen therapy alone is sufficient. In patients with worsening respiratory failure high flow nasal oxygen therapy (HFNOT) may be effective. The continuous positive airway pressure (CPAP) and non-invasive ventilation (NIV) methods can be used to a limited extent. With further disease progression, invasive ventilation must be used and in special situations, extracorporeal membrane oxygenation (ECMO) can also be administered.The authors of this article set themselves the goal of presenting the most current knowledge about the epidemiology and patho-physiology of respiratory failure in COVID-19, as well as the methods of its treatment. Given the dynamics of the developing pandemic, this is not an easy task as new scientific data is presented almost every day. However, we believe the knowledge contained in this study will help doctors care for patients with COVID-19. The main target audience of this study is not so much pneumonologists or intensivists who have extensive experience in the application of the techniques discussed here, but rather doctors of other specializations who must master new skills in order to help patients during the time of a pandemic

Potential benefits and hazards associated with the use of e-cigarettes — a guide for practitioners and current status in Poland

The use of electronic cigarettes has dynamically increased over the last few years. Meanwhile, the knowledge regarding their safety has been rapidly changing, which could be a challenge for a medical practitioner. The purpose of this review is to summarize the latest reports and to verify statements on e-cigarettes’ influence on health, including in the context of the ongoing SARS-CoV-2 pandemic. Awareness of the benefits of e-cigarettes can provide vital support for doctors caring for patients who smoke tra-ditional cigarettes. Nevertheless, attention should be paid to the dangers of the medically unjustified use of electronic cigarettes. Despite the idea of releasing e-cigarettes into the market as a harmless alternative to traditional cigarettes, this product also has a negative impact on health. Replacing traditional cigarettes with e-cigarettes provides well-documented benefits to patients with certain indications such as hypertension and asthma, as well as to smokers who intend to minimize the negative effects of passive smoking on their environment. Moreover, it could be valuable for patients who are willing to permanently overcome a nicotine addiction, especially when previous attempts to quit smoking with nicotine replacement therapy (NRT) monotherapy were unsuccessful. Electronic cigarettes are a rapidly developing technology and an innovative form of a well-known addiction, so it is essential for practitioners to stay informed

Chosen Problems of Estimating the Value of Intellectual Capital of the Company

The aim of the modern enterprise is an increase in the broader values. An important component and also factor in the company's value is its intellectual capital. One of the most important problems of theory and practice in this area is the measurement and reporting of intellectual capital of the company. There are two kind of approaches, namely the approach of intellectual capital valuation based on market value of the company and approach to valuation of various components of intellectual capital. This article addresses the methodological problems of estimating the value of intellectual capital in the first of these approaches. The Authors have indicated that the previous methodology for valuation of intellectual capital, in particular, in the formula based on the difference of the market value of companies and its book value has an important methodological flaw. Therefore the Authors proposed two slightly different formulas for estimating the value of intellectual capital

Potential Benefits and Hazards Associated with the Use of E-Cigarettes—A Guide for Practitioners and Current Status in Poland

The use of electronic cigarettes has dynamically increased over the last few years. Meanwhile, the knowledge regarding their safety has been rapidly changing, which could be a challenge for a medical practitioner. The purpose of this review is to summarize the latest reports and to verify statements on e-cigarettes’ influence on health, including in the context of the ongoing SARS-CoV-2 pandemic. Awareness of the benefits of e-cigarettes can provide vital support for doctors caring for patients who smoke tra-ditional cigarettes. Nevertheless, attention should be paid to the dangers of the medically unjustified use of electronic cigarettes. Despite the idea of releasing e-cigarettes into the market as a harmless alternative to traditional cigarettes, this product also has a negative impact on health. Replacing traditional cigarettes with e-cigarettes provides well-documented benefits to patients with certain indications such as hypertension and asthma, as well as to smokers who intend to minimize the negative effects of passive smoking on their environment. Moreover, it could be valuable for patients who are willing to permanently overcome a nicotine addiction, especially when previous attempts to quit smoking with nicotine replacement therapy (NRT) monotherapy were unsuccessful. Electronic cigarettes are a rapidly developing technology and an innovative form of a well-known addiction, so it is essential for practitioners to stay informed

Rapid Oncological Diagnosis of Lung Cancer: Specific Facility Experience

Introduction: In order to improve diagnosis procedure by public health service, an organizational solution called Rapid Oncological Therapy has been introduced. The introduction of this program caused criticism of the medical community, and state control authorities showed irregularities in its functioning in medical clinics. Its aim was to assess this process among lung cancer patients hospitalized in the Clinic for 9 months. Material and methods: After the analysis of imaging tests, the patients were qualified for invasive tests (bronchoscopy, EBUS). Patients with histopathological diagnosis of NSCLC were subjected to molecular diagnostics. After completing the diagnosis and establishing the final diagnosis, the patient\u27s forfeiture was presented at the clinical meeting. Results: The analysis involved 209 patients who had a DILO card issued. 156 patients were diagnosed with lung cancer and qualified for the consulate. Among the histopathological types, NSCLC dominated—80%. SCLC was 17% of the types. By the decision made on medical case conference, 135 patients have been qualified for casual treatment, among others 12% surgical treatment; 47% chemotherapy, 18% radiotherapy; 8% chemo-radiotherapy. An average waiting time for diagnosis process to begin, after DILO card has been issued was 16.33 (±18.78) days, an average hospitalization and diagnosis time was 9.16 (±6.61) days. Around 31.3 (±14.93) days on average have passed from the start of diagnostical hospitalization until beginning of the causal treatment. Conclusions: In a multi-specialist center, it is possible to develop a care model for lung cancer patients, consistent with Rapid Oncological Diagnosis

Immunomodulatory Molecules On Lung Cancer Stem Cells From Lymph Nodes Aspirates

Over the past decade, immune checkpoint inhibitors have revolutionized the treatment of non-small cell lung cancer (NSCLC). Unfortunately, not all patients benefit from PD-(L)1 blockade, yet, the PD-L1 tumor cell expression is the only approved biomarker, and other biomarkers have been investigated. In the present study, we analyzed the presence of immunomodulatory molecules: PD-L1, CD47, CD73, Fas, and FasL on mature tumor cells (MTCs) and cancer stem cells (CSCs) in lymph nodes (LNs) aspirates and refer it to the lymphocyte subpopulation in peripheral blood (PB). PB samples and LNs aspirates obtained during the endobronchial ultrasound-guided transbronchial needle aspiration (EBUS/TBNA) procedure of 20 patients at different stages of NSCLC. The cells were analyzed by multiparameter flow cytometry. We reported the higher frequency of MTCs and CSCs expressing the investigated immunomodulating molecules in metastatic LNs than in nonmetastatic. The expression of CD47 and PD-L1 was significantly higher on CSCs than on MTCs. Among the lymphocyte subpopulation in PB, we observed a higher frequency of PD-1+ CD8 T cells and Fas+ CD8 T cells in patients with confirmed metastases than in nonmetastatic. Next, we found that the percentage of FasL+ MTCs correlated with the frequency of Fas+ CD3 T cells in LNs aspirates and Fas+ CD8 T cells in PB. Finally, we found that patients with metastatic disease had a significantly higher FasL+/Fas+ MTCs ratio than patients with nonmetastatic disease. Both MTCs and CSCs express different immunomodulatory molecules on their surface. The frequency of FasL+ MTCs associates with altered distribution of Fas+ lymphocyte subpopulations in LNs and PB

Treatment of Acute Respiratory Failure in the Course of COVID-19. Practical Hints from the Expert Panel of the Assembly of Intensive Care and Rehabilitation of the Polish Respiratory Society

In 2019, a pandemic began due to infection with a novel coronavirus, SARS-CoV-2. In many cases, this coronavirus leads to the development of the COVID-19 disease. Lung damage in the course of this disease often leads to acute hypoxic respiratory failure and may eventually lead to acute respiratory distress syndrome (ARDS). Respiratory failure as a result of COVID-19 can develop very quickly and a small percent of those infected will die because of it. There is currently no treatment for COVID-19, therefore the key therapeutic intervention centers around the symptomatic treatment of respiratory failure. The main therapeutic goal is to main-tain gas exchange, mainly oxygenation, at an appropriate level and prevent the intensification of changes in the lung parenchyma. Depending on the severity of hypoxemia different techniques can be used to improve oxygenation. Medical staff dealing with COVID-19 patients should be familiar with both, methods used to treat respiratory failure and the epidemiological risks arising from their use. In some patients, conventional (passive) oxygen therapy alone is sufficient. In patients with worsening respiratory failure high flow nasal oxygen therapy (HFNOT) may be effective. The continuous positive airway pressure (CPAP) and non-invasive ventilation (NIV) methods can be used to a limited extent. With further disease progression, invasive ventilation must be used and in special situations, extracorporeal membrane oxygenation (ECMO) can also be administered. The authors of this article set themselves the goal of presenting the most current knowledge about the epidemiology and patho-physiology of respiratory failure in COVID-19, as well as the methods of its treatment. Given the dynamics of the developing pandemic, this is not an easy task as new scientific data is presented almost every day. However, we believe the knowledge contained in this study will help doctors care for patients with COVID-19. The main target audience of this study is not so much pneumonologists or intensivists who have extensive experience in the application of the techniques discussed here, but rather doctors of other specializations who must master new skills in order to help patients during the time of a pandemic